MARCH 19TH

POOR RICHARD'S ALMANACK

Sam's Religion is like a Chedder Cheese, 'tis made of the milk of one & twenty Parishes.

— Benjamin Franklin,1734

AMERICANREVOLUTION.ORG

DOMESTIC MEDICINE

CHAP. XXXIX.

OF THE SCURVY.

THIS disease prevails chiefly in cold northern
countries especially in low damp situations, near large marshes,
or great quantities of stagnating water. Sedentary people, of
a dull melancholy disposition, are most subject to it. It proves
often fatal to sailors on long voyages, particularly in ships
that are not properly ventilated, have many people on board,
or where cleanliness is neglected.

IT is not necessary to mention the different
species into which this disease has been divided, as they differ
from one another chiefly in degree. What is called the land
scurvy, however, is seldom attended with those highly putrid
symptoms which appear in patients who have been long at sea,
and which, we presume, are rather owing to confined air, want
of exercise, and the unwholesome food eat by sailors on long
voyages, than to any specific difference in the disease.

CAUSES. - The scurvy is occasioned by cold
moist air; by the long use of saIted or smoke-dried provisions,
or any kind of food that is hard of digestion, and affords little
nourishment. It may also proceed from the suppression of customary
evacuations: as the menses, the haemorrhoidal flux, &c.
It is sometimes owing to a hereditary taint, in which case a
very small cause will excite the latent disorder. Grief, fear,
and other depressing passions, have great tendency both to excite
and aggravate this disease. The same observation holds with regard
to neglect of cleanliness; bad clothing; the want of proper exercise;
confined air; unwholesome food; or any disease which greatly
weakens the body, or vitiates the humours.

SYMPTOMS. - This disease may be known by unusual
weariness, heaviness, and difficulty of breathing, especially
after motion; rottenness of the gums, which are apt to bleed
on the slightest touch; a stinking breath; frequent bleeding
at the nose; crackling of the joints; difficulty of walking;
sometimes a swelling and sometimes a falling away of the legs,
on which there are livid, yellow, or violet coloured spots; the
face is generally of a pale or leaden colour. As the disease
advances, other symptoms come on as rottenness of the teeth,
haemorrhages, or discharges of blood from different parts of
the body, foul obstinate ulcers, pains in various parts, especially
about the breast, dry scaly eruptions all over the body, &c.
At last a wasting or hectic fever comes on, and the miserable
patient is often carried off by a dysentery, a diarrhoea, a dropsy,
the palsy, fainting fits, or a mortification of some of the bowels.

CURE. - We know no way of curing this disease
but by pursuing a plan, directly opposite to that which brings
it on. It proceeds from a vitiated state of the humours, occasioned
by errors in diet, air, or exercise; and this cannot be removed
but by a proper attention to these important articles.

IF the patient has been obliged to breathe
a cold, damp, or confined air, he should be removed, as soon
as possible, to a dry, open, and moderately warm one. If there
is reason to believe that the disease proceeds from a sedentary
life, or depressing passions, as grief, fear, &c. the patient
must take daily as much exercise in the open air as he can bear,
and his mind should be diverted by cheerful company and other
amusements. Nothing has a greater tendency either to prevent,
or to remove this disease, than constant cheerfulness and good
humour. But this, alas! is seldom the lot of persons afflicted
with the scurvy; they are generally surly, peevish, and morose.
When the scurvy has been brought on by a long use of salted provisions,
the proper medicine is a diet consisting chiefly of fresh vegetables;
as oranges, apples, lemons, limes, tamarinds, water-cresses,
scurvy-grass, brook-lime, &c. The use of these, with milk,
pot-herbs, new bread, and fresh beer or cyder, will seldom fail
to remove a scurvy of this kind, if taken before it be too far
advanced; but to have this effect, they must be persisted in
for a considerable time. When fresh vegetables cannot be obtained,
pickled or preserved ones may be used; and where these are wanting,
recourse must be had to the chymical acids. All the patient's
food and drink should in this case be sharpened with cream of
tartar, elixir of vitriol, vinegar, or the spirit of sea-salt.

THESE things however will more certainly prevent
than cure the scurvy; for which reason sea-faring people, especially
on long voyages, ought to lay in plenty of them. Cabbages, onions,
gooseberries, and many other vegetables, may be kept a long time
by pickling, preserving, &c. and when these fail,
the chymical acids, recommended above, which will keep for any
length of time, may be used. We have reason to believe, if ships
were well ventilated, had good store of fruits, greens, cyder,
&c. laid in, and if proper regard were paid to cleanliness
and warmth, the sailors would be the most healthy people in the
world, and would seldom suffer either from the scurvy or putrid
fevers, which are so fatal to that useful set of men; but it
is too much the temper of such people to despise all precaution;
they will not think of any calamity till it overtakes them, when
it is too late to ward off the blow.

IT must indeed be owned, that many of them
have it not in their power to make the provision we are speaking
of; but in this case it is the duty of their employers to make
it for them; and no man ought to engage in a long voyage without
having these articles secured.

I HAVE often seen very extraordinary effects
in the land-scurvy from a milk diet. This preparation of Nature
is a mixture of animal and vegetable properties, which of all
others is the most fit for restoring a decayed constitution,
and removing that particular acrimony of the humours, which seems
to constitute the very essence of the scurvy, and many other
diseases. But people despise this wholesome and nourishing food,
because it is cheap, and devour with greediness, flesh, and fermented
liquors, while milk is only deemed fit for their hogs.

THE most proper drink in the scurvy is whey
or butter-milk. When these cannot be had, sound cyder, perry,
or spruce-beer, may be used. Wort has likewise been found to
be a proper drink in the scurvy, and may be used at sea, as malt
will keep during the longest voyage. A decoction of the tops
of the spruce fir is likewise proper. It may be drank in the
quantity of an English pint twice a-day. Tar-water may be used
for the same purpose, or decoctions of any of the mild mucilaginous
vegetables; as sarsaparilla, marsh-mallow roots, &c. Infusions
of the bitter plants, as ground-ivy, the lesser centaury, marsh-trefoil,
&c. are likewise beneficial. I have seen the peasants in
some parts of Britain express the juice of the last-mentioned
plant, and drink it with good effect in those foul scorbutic
eruptions with which they are often troubled in the spring season.

HARROWGATE water is certainly an excellent
medicine in the land-scurvy. I have often seen patients who had
been reduced to most deplorable condition by this disease, greatly
relieved by drinking the sulphur-water, and bathing in it. The
chalybeate-water may also be used with advantage, especiaIly
with a view to brace the stomach after drinking the sulphur-water,
which, though it sharpens the appetite, never fails to weaken
the powers of digestion.

A SLIGHT degree of scurvy may be carried off
by frequently sucking a little of the juice of a bitter orange,
or a lemon. When the disease affects the gums only, this practice,
if continued for some time, will generally carry it off. We would
however recommend the bitter-orange as greatly preferable to
lemon; it seems to be as good a medicine, and is not near so
hurtful to the stomach. Perhaps our own sorrel may be little
inferior to either of them.

ALL kinds of sallad are good in the scurvy,
and ought to be eat very plentifully, as spinage, lettuce, parsley,
celery, endive, radish, dandelion, &c. It is amazing to see
how soon fresh vegetables in the spring cure the brute animals
of any scab or foulness which is upon their skins. It is reasonable
to suppose that their effects would be as great upon the human
species, were they used in proper quantity for a sufficient length
of time.

I HAVE sometimes seen good effects in scorbutic
complaints of very long standing, from the use of a decoction
of the roots of water-dock. It is usually made by boiling a pound
of the fresh root in six English pints of water, till about one-third
of it be consumed. The dose is from half a pint to a whole pint
of the decoction every day. But in all the cases where I have
seen it prove beneficial, it was made much stronger, and drank
in larger quantities. The safest way, however, is for the patient
to begin with small doses, and increase them both in strength
and quantity as he finds his stomach will bear it. It must be
used for a considerable time. I have known some who had used
it for several years, before they were sensible of any benefit,
but who, nevertheless, were cured by it at length.

THE LEPROSY, which was so common in this country
long ago, seems to have been near a-kin to the scurvy. Perhaps
its appearing so seldom now, may be owing to the inhabitants
of Britain eating more vegetable food than formerly, living more
upon tea, and other diluting diet, using less salted meat, being
more cleanly, better lodged and clothed, &c. - For the cure
of this disease we would recommend the same course of diet and
medicine as in the scurvy.

OF THE
SCCROPHULA, OR KING'S EVIL.

THIS disease chiefly affects the glands, especially
those of the neck. Children and young persons of a sedentary
life are very subject to it. It is one of those diseases which
may be removed by proper regimen, but seldom yields to medicine.
The inhabitants of cold, damp, marshy countries are most liable
to the scrophula.

CAUSES. - This disease may proceed from a
hereditary taint, from a scrophulous nurse, &c. Children
who have the misfortune to be born of sickly parents whose constitutions
have been greatly injured by the pox, or other chronic diseases,
are apt to be affected with the scrophula. It may likewise proceed
from such diseases as weaken the habit or vitiate the humours,
as the small-pox, measles, &c. External injuries, as blows,
bruises, and the like, sometimes produce scrophulous ulcers;
but we have reason to believe, when this happens, that there
has been a predisposition in the habit to this disease. In short,
whatever tends to vitiate the humours or relax the solids, paves
the way to the scrophula; as the want of proper exercise, too
much heat or cold, confined air, unwholesome food, bad water,
the long use of poor, weak, watery aliments, the neglect of cleanliness,
&c. Nothing tends more to induce this disease in children
than allowing them to continue long wet. The scrophula, as well
as the rickets, is found to prevail in large manufacturing towns,
where people live gross, and lead sedentary lives.

SYMPTOMS. - At first small knots appear under
the chin or behind the ears, which gradually increase In number
and size, till they form one large hard tumour. This often continues
for a long time without breaking, and when it does break, it
only discharges a thin sanies or watery humour. Other
parts of the body are likewise liable to its attack, as the arm-pits,
groins, feet, hands, eyes, breasts, &c. Nor are the internal
parts exempt from it. It often affects the lungs, liver, or spleen;
and I have frequently seen the glands of the mysentery greatly
enlarged by it.

THOSE obstinate ulcers which break out upon
the feet and hands with swelling, and little or no redness, are
of the scrophulous kind. They seIdom discharge good matter, and
are exceedingly difficult to cure. The white swellings
of the joints seem likewise to be of this kind. They are with
difficulty brought to a suppuration, and when opened they only
discharge a thin ichor. There is not a more general symptom of
the scrophula than a swelling of the upper lip and nose.

REGIMEN. - As this disease proceeds, in a
great measure, from relaxation, the diet ought to be generous
and nourishing, but at the same time light and of easy digestion;
as well fermented bread, made of sound grain, the flesh and broth
of young animals, with now and then a glass of generous wine,
or good ale. The air ought to be open, dry, and not too cold,
and the patient should take as much exercise as he can bear.
This is of the utmost importance. Children who have enough of
exercise are seldom troubled with the scrophula.

MEDICINE - The vulgar are remarkably credulous
with regard to the cure of the scrophula, many of them believing
in the virtue of the royal touch, that of the seventh son, &c.
The truth is, we know but little either of the nature or cure
of this dlsease, and where reason or medicines fail, superstition
always comes in their place. Hence it is, that in diseases which
are the most difficult to understand, we generally hear of the
greatest number of miraculous cures being performed. Here, however,
the deception is easily accounted for. The scrophula, at a certain
period of life, often cures of itself; and, if the patient happens
to be touched about this time, the cure is imputed to the touch,
and not to Nature, who is really the physician. In the same way
the insignificant nostrums of quacks and old women often gain
applause when they deserve none.

THERE is nothing more pernicious than the
custom of plying children in the scrophula with strong purgative
medicines. People imagine it proceeds from humours which must
be purged off, without considering that these purgatives increase
the debility, and aggravate the disease. It has indeed been found,
that keeping the body gently open, for some time, especially
with sea-water, has a good effect; but this should only be given
in gross habits, and in such quantity as to procure one, or at
most two stools every day.

BATHING in the salt water has likewise a very
good effect, especially in the warm season. I have often known
a course of bathing in salt water, and drinking it in such quantities
as to keep the body gently open, cure a scrophula, after many
other medicines had been tried in vain. When salt water cannot
be obtained, the patient may be bathed in fresh water, and his
body kept open by small quantities of salt and water, or some
other mild purgative.

NEXT to cold bathing, and drinking the salt-water,
we would recommend the Peruvian bark. The cold bath may be used
in summer, and the bark in winter. To an adult half a drachm
of the bark in powder may be given, in a glass of red wine, four
or five times a-day. Children, and such as cannot take it in
substance, may use the decoction made in the following manner:

BOIL an ounce of Peruvian bark and a drachm
of Winter's bark, both grossly powdered, in an English quart
of water to a pint: towards the end half an ounce of sliced liquorice-root,
and a handful of raisins may be added, which will both render
the decoction less disagreeable, and make it take up more of
the bark. The liquor must be strained, and two, three, or four
table-spoonfuls, according to the age of the patient. given three
times a-day.

THE Moffat and Harrowgate waters, especially
the latter, are likewise very proper medicines in the scrophula.
They ought not however to be drank in large quantities, but should
be taken so as to keep the body gently open, and must be used
for a considerable time.

THE hemlock may sometimes be used with advantage
in the scrophula. Some lay it down as a general rule, that the
sea-water is most proper before there are any suppuration or
symptoms of tabes; the Peruvian bark, when there are running
sores, and a degree of hectic fever; and the hemlock in old inveterate
cases, approaching to the scirrhous or cancerous state. Either
the extract or the fresh juice of this plant may be used. The
dose must be small at first, and increased gradually as far as
the stomach is able to bear it.

EXTERNAL applications are of little use. Before
the tumour breaks, nothing ought to be applied to it, unless
a piece of flannel, or something to keep it warm. After it breaks,
the sore may be dressed with some digestive ointment. What I
have always found to answer best, was the yellow basilicon mixed
with about a sixth or eighth part of its weight of red precipitate
of mercury. The sore may be dressed with this twice a-day; and
if it be very fungous, and does not digest well, a larger proportion
of the precipitate may be added.

MEDICINES which mitigate this disease, though
they do not cure it, are not to be despised If the patient can
be kept alive by any means till he arrives at the age of puberty,
he has a great chance to get well; but if he does not recover
at this time, in all probability he never will.

THERE is no malady which parents are so apt
to communicate to their offspring as the scrophula, for which
reason people ought to beware of marrying into families affected
with this disease.

FOR the means of preventing the scrophula,
we must refer the reader to the observations on nursing, at the
beginning of the book.

OF THE
ITCH.

THOUGH this disease is commonIy communicated
by infection, yet it seldom prevails where due regard is paid
to cleanliness, fresh air, and wholesome diet. It generally appears
in form of small watery pustules, first about the wrists, or
between the fingers; afterwards it affects the arms, legs, thighs,
&c. These pustules are attended with an intolerable itching,
especially when the patient is warm a-bed, or sits by the fire.
Sometimes indeed the skin is covered with large blotches or scabs,
and at other times with a white scurf, or scaly eruption. This
last is called the dry itch, and is the most difficult to cure.

THE itch is seldom a dangerous disease, unless
when it is rendered so by neglect, or improper treatment. If
it be suffered to continue too long, it may vitiate the whole
mass of humours; and, if it be suddenly drove in, without proper
evacuations, it may occasion fevers, inflammations of the viscera,
or other internal disorders.

THE best medicine yet known for the itch is
sulphur, which ought to be used both externally and internally.
The parts most affected may be rubbed with an ointment made of
the flowers of sulphur, two ounces; crude sal ammoniac finely
powdered two drachms; hog's lard, or butter, four ounces. If
a scruple or half a drachm of the essence of lemon be added,
It will entirely take away the disageeeable smell. About the
bulk of a nutmeg of this may be rubbed upon the extremities,
at bed-time, twice or thrice a-week. It is seldom necessary to
rub the whole body, but when it is, it ought to be done all at
once, but by turns, as it is dangerous to stop too many pores
at the same tlme.

BEFORE the patient begins to use the ointment,
he ought, if he be of a full habit, to bleed or take a purge
or two. It will likewise be proper, during the use of it, to
take every night and morning as much of the flower of brimstone
and cream of tartar, in a little treacle or new milk, as will
keep the body gently open. He should beware of catching cold,
should wear more clothes than usual, and take every thing warm.
The same clothes, the linen excepted, ought to be worn all the
time of using the ointment and such clothes as have been worn
while the patient was under the disease, are not to be used again,
unless they have been fumigated with brimstone, and thoroughly
cleaned, otherwise they will communicate the infection anew.
Sir John Pringle observes that, though this disease may seem
trifling, there is no one in the army that is more troublesome
to cure, as the infection often lurks in clothes, &c. and
breaks out a second, or even a third time. The same inconveniency
occurs in private families, unless particular regard is paid
to the changing or cleaning of their clothes, which last is by
no means an easy operation.

I NEVER knew brimstone, when used as directed
above, fail to cure the itch; and I have reason to believe, that,
if duly persisted in, it never will fail; but if it be only used
once or twice, and cleanliness neglected, it is no wonder if
the disorder returns. The quantity of ointment mentioned above
will generally be sufficient for the cure of one person; but,
if any symptoms of the disease should appear again, the medicine
may be repeated. It is both more safe and efficacious when persisted
in for a considerable time, than when a large quantity is applied
at once. As most people dislike the smell of sulphur, they may
use, in its place, the powder of white hellebore root made up
into an ointment, in the same manner, which will seldom fail
to cure the itch.

PEOPLE ought to be extremely cautious lest
they take other eruptions for the itch; as the stoppage of these
may be attended with fatal consequences. Many of the eruptive
disorders to which children are liable, have a near resemblance
to this disease; and I have often known infants killed by being
rubbed with greasy ointments that made these eruptions strike
suddenly in, which Nature had thrown out to preserve the patient's
life, or prevent some other malady.

MUCH mischief is likewise done by the use
of mercury in this disease. Some persons are so fool hardy as
to wash the parts affected with a strong solution or the corrosive
sublimate. Others use the mercurial ointment, without taking
the least care either to avoid cold, keep the body open, or observe
a proper regimen. The consequences of such conduct may be easily
guessed. I have known even the mercurial girdles produce tragical
effects, and would advise every person, as he values his health,
to beware how he uses them. Mercury ought never to be used as
a medicine without the greatest care. Ignorant people look upon
these girdles as a kind of charm, without considering that the
mercury enters the body.

IT is not to be told what mischief is done
by using mercurial ointment for curing the itch and killing vermin;
yet it is unnecessary for either: The former may be always more
certainly cured by sulphur, and the latter will never be found
where due regard is paid to cleanliness.

THOSE who would avoid this detestable disease
ought to beware of infected persons, to use wholesome food, and
to study universal cleanliness. The itch is now by cleanliness
banished from every genteel family in Britain. It still however
prevails among the poorer sort of peasants in Scotland, and among
the manufacturers in England. These are not only sufficient to
keep the seeds of the disease alive, but to spread the infection
among others. It were to be wished that some effectual method
could be devised for extirpating it altogether. Several country
clergymen have told me, that by getting such as were infected
cured, and strongly recommending an attention to cleanliness,
they have banished the itch entirely out of their parishes. Why
might not others do the same?